Provider Demographics
NPI:1003308560
Name:O'HARA, THOMAS ALEXANDER (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALEXANDER
Last Name:O'HARA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EAST HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AA
Mailing Address - Zip Code:30909-5650
Mailing Address - Country:US
Mailing Address - Phone:706-787-5811
Mailing Address - Fax:706-787-1745
Practice Address - Street 1:300 EAST HOSPITAL STREET
Practice Address - Street 2:
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30909-5650
Practice Address - Country:US
Practice Address - Phone:706-787-5811
Practice Address - Fax:706-787-1745
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA83743OtherGEORGIA COMPOSITE MEDICAL BOARD